RESUMEN
OBJECTIVE: To evaluate the sterility of citrate phosphate dextrose adenine (CPDA-1) anticoagulant when sampled from blood collection bags in a multi-dose manner. SAMPLE: 10 pre-filled CPDA-1 blood collection bags; 46 bacterial and 28 fungal culture result reports. PROCEDURES: 10 CPDA-1 blood collection bags were split into 2 equal groups and stored at either room temperature (24 °C) or refrigerator temperature (5 °C) for 30 days. Two bags in each group were designated as controls. Beginning on day 0 a 1.0 mL aliquot was withdrawn from each experimental bag and submitted for bacterial culture (aerobic and anaerobic) every 5 days, and fungal culture every 10 days. All 10 bags were sampled on day 30. Bacterial and fungal culture results were compiled and interpreted. RESULTS: 46 CPDA-1 aliquots were cultured, resulting in 2 positive microbial isolates: Bacillus was cultured from a previously unopened experimental bag on day 0, and Candida was cultured from a refrigerated experimental bag on day 30. Both positives are thought to represent post-sampling contamination, though these suspicions cannot be confirmed in the bag yielding Candida due to a lack of subsequent data. All other samples were negative for microbial growth. CLINICAL RELEVANCE: CPDA-1 blood collection bags stored at either 24 °C or 5 °C can be used in a multi-dose manner for up to 20 days when each sample is obtained aseptically. These results support the clinician's ability to utilize the contents of 1 bag multiple times rather than discarding the bag after a single use.
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Conservación de la Sangre , Glucosa , Animales , Conservación de la Sangre/veterinaria , Glucosa/farmacología , Fosfatos , Adenina/farmacologíaRESUMEN
OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the Baptist Health High Risk Falls Assessment (BHHRFA). BACKGROUND: The cost of falls and the potential for increased patient morbidity and mortality necessitate the development of a psychometrically sound assessment. METHODS: Based on pilot data, a multisite study was conducted. Assessments were collected on 21 medical-surgical units, 1 rehabilitation unit, 1 psychiatric unit, and 3 critical care units (N = 241599). Sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated. Clinical usefulness in terms of assessment performance time was addressed. RESULTS: Psychometric properties were within a desirable range for each site, critical care patients, and all participants (sensitivity, 0.64-1.00; specificity, 0.50-0.70; and DOR, 4.73-7.0). Although sensitivity at 1 site was high (0.84), specificity was low (0.37). CONCLUSIONS: Results suggest that the BHHRFA is clinically useful for adult inpatients across acute care settings.
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Accidentes por Caídas/estadística & datos numéricos , Pacientes Internos/psicología , Medición de Riesgo/métodos , Anciano , Anciano de 80 o más Años , Cuidados Críticos , Femenino , Humanos , Pacientes Internos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Psicometría , Reproducibilidad de los Resultados , Factores de RiesgoRESUMEN
BACKGROUND: Effective management of pain begins with accurate assessment of its presence and severity, which is difficult in critically ill patients. The Critical-Care Pain Observation Tool (CPOT) was developed to evaluate behaviors associated with pain and validated primarily with cardiac surgical patients. OBJECTIVE: The purpose of this study was to examine reliability and validity of the CPOT in a general population of adult, critically ill patients. METHODS: Using a sample of 75 patients from critical care units of a community hospital, pain was evaluated at 3 times (prerepositioning, during repositioning, and postrepositioning) by 2 evaluators, using 3 different pain scales: CPOT; Faces, Legs, Activity, Cry, and Consolability (FLACC) scale; and Pain Intensity Numeric Rating Scale. RESULTS: Results indicated that reliability and validity of the CPOT were acceptable. Interrater reliability was supported by strong intraclass correlations (ranging from 0.74 to 0.91). For criterion-related validity, significant associations were found between CPOT scores and both FLACC (0.87-0.92) and Pain Intensity Numeric Rating Scale (0.50-0.69) scores. Discriminant validity was supported by significantly higher scores during repositioning (mean, 1.85) versus at rest (pre mean, 0.60; post mean, 0.65). DISCUSSION: The CPOT is an acceptable behavioral pain assessment scale for use in the general critical care patient population and is more appropriate for use with adults than the FLACC.
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Procedimientos Quirúrgicos Cardíacos , Cuidados Críticos/métodos , Enfermedad Crítica , Manejo del Dolor , Dimensión del Dolor/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los ResultadosRESUMEN
This study evaluated the effects of a single intraperitoneal injection of N-methyl-N-nitrosourea (MNU) in citrate buffer (pH 4.5) at a dose of 75 mg/kg in thirty male and thirty female p53+/- mice followed by a six-month observation period. Fifteen control mice per sex received a single intraperitoneal injection of citrate buffer. Fifty-six of sixty mice treated with MNU died or were sacrificed before the end of the observation period. Twenty-four males and twenty-seven females treated with MNU developed malignant lymphoma of the thymus; of these, twenty-three males and twenty-seven females had corresponding enlargement or masses in the thymus at necropsy. Lymphoblasts in thymic lymphomas stained positively for mouse CD3 antigen, indicating a T-cell lineage. One control female mouse had malignant lymphoma of the spleen that did not involve the thymus. Nine males and five females treated with MNU had adenomas or adenocarcinomas of the small intestine, whereas no intestinal neoplasms were observed in control mice. These findings support the use of a single dose of MNU as a positive control chemical in six-month p53+/- mouse carcinogenicity studies and suggest that examination of the thymus alone is sufficient to evaluate the validity of the model system.